The Association Between the Impact of COVID-19 and Internalizing Problems Among Children and Adolescents with ADHD: The Moderating Role of Parental Anxiety.

Previous research has identified an increase in internalizing problems during the COVID-19 pandemic in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Additionally, it has been observed that parents of children with ADHD had elevated levels of anxiety during the pandemic. The current study aimed to longitudinally assess whether the impact of COVID-19 was associated with internalizing problems in children and adolescents with ADHD during the middle (Time 1-Spring 2021 [T1]) and end (Time 2-Fall/Winter 2022 [T2]) of the pandemic, and whether parental anxiety moderated this relationship over time. Canadian parents of youth with ADHD (aged 3-18 years old) completed online questionnaires assessing their child's depression and anxiety symptoms, their own anxiety symptoms, and the pandemic's impact on their child, both at T1 (N = 278) and T2 (N = 89). The results indicated that the impact of COVID-19 on children at T1 was a unique predictor of child internalizing problems at T1 but not at T2. While parental anxiety did not moderate this association cross-sectionally, it was a significant moderator longitudinally. More specifically, low parental anxiety at T1 positively moderated the association between the COVID-19 impact on children at T1 and child internalizing problems at T2. The results highlight the importance of providing on-going psychological support for children and adolescents with ADHD and emphasize the need to aid parents in effectively supporting their children during the process of pandemic recovery.

Positive Childhood Experiences and the Indirect Relationship With Improved Emotion Regulation in Adults With ADHD Through Social Support.

OBJECTIVE: To identify direct and indirect associations between PCEs and social support to emotion regulation outcomes in adults with ADHD. METHOD: Adults with ADHD (n = 81) reported PCEs, current social support, and emotion regulation. Conditional effects modeling examined the direct and indirect relationships between PCEs and emotion dysregulation through social support. RESULTS: Higher PCEs were indirectly related to improved emotion regulation through increased social support generally (ß = -.70, 95% CI [-1.32, -0.17], and specifically through belonging (ß = -.43, 95% CI [ -0.87, -0.05], self-esteem (ß = -.61, 95% CI [-1.08, -0.27], and tangible social support (ß = -.50, 95% CI [-1.07, -0.02]. CONCLUSIONS: PCEs may protect emotion regulation in adults with ADHD through social support, possibly through facilitating social connections, increasing access to social support, and sustaining emotion regulation strategies.

"I'm Doing Okay": Strengths and Resilience of Children With and Without ADHD.

BACKGROUND: The body of research directed at understanding the strengths and resilience of this population is growing. Research has indicated there are strengths for individuals with ADHD, and found factors important for promoting good outcomes. This study investigates positive qualities by examining the strengths and resilience of children with and without ADHD. METHODS: The final sample included 56 children between the ages of 10 and 17 years (ADHD: n = 38; without ADHD: n = 18). RESULTS: Children in both groups tended to report average levels of strengths and resilience except for school functioning, where significant differences were found between groups. Significant correlations between strengths and resilience for both groups were found. Only family involvement was not significantly correlated with resilience for the without ADHD group. CONCLUSIONS: Results from this study emphasize the importance of taking a strength-based perspective when working with children diagnosed with ADHD.

Miss. Diagnosis: A Systematic Review of ADHD in Adult Women.

OBJECTIVE: The aim of this review was to explore the impact of living with undiagnosed ADHD and adult diagnosis on women. METHOD: A systematic literature search was completed using three databases. Eight articles were considered relevant based on strict inclusion criteria. Thematic analysis was used to analyze the results of the articles. RESULTS: Four key themes emerged: Impacts on social-emotional wellbeing, Difficult relationships, Lack of control, and Self-acceptance after diagnosis. CONCLUSION: This knowledge can be used to advance the understanding of ADHD in adult women and the implications for late diagnosis in women.

The relation between symptoms of ADHD and symptoms of eating disorders in university students.

There is evidence to suggest an association between Attention-Deficit/Hyperactivity Disorder (ADHD) and eating disorders (EDs). As those with subclinical symptoms of ADHD or ED often experience impairment, this cross-sectional study examined the relationship between ADHD symptoms and ED symptoms in a predominately subclinical undergraduate population. Students (n = 133; 80% female) completed questionnaires measuring ADHD and ED symptomatology. The relation between overall ADHD symptoms and ED symptoms was examined using linear regression; findings indicated that higher ADHD symptoms significantly predicted higher ED symptoms. When symptoms of both disorders were further delineated, inattentive ADHD symptoms consistently predicted higher ED symptoms (bulimia, body dissatisfaction, and drive for thinness). A number of mechanisms may explain the association between ADHD and ED symptoms, including shared executive function deficits, poor emotion regulation, and mood challenges. These mechanisms may have clinical relevance in ADHD and ED treatment and prevention efforts.

Positive Child Personality Factors in Children with ADHD.

OBJECTIVE: Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder. While previous studies have shown substantial impact of ADHD across multiple domains, relatively little attention has been devoted to studying positive personality factors in individuals with ADHD. To address this, the current study examined strength-based factors in children with ADHD in relation to their social skills. METHOD: Sixty-four children (aged 8-12 years) with ADHD completed questionnaires related to their social skills and strength-based factors (e.g., optimism, resilience, self-concept, and coping skills). RESULTS: Findings indicated significant differences between different levels of social skills in children with ADHD, with children with higher social skills reporting higher levels of resiliency, greater behavioral competence, and greater prosocial attitudes than those with lower social skills. CONCLUSIONS: The results highlight the importance of fostering strong social skills in children with ADHD, leading them to perceive themselves as competent and resilient.

The Demands of Performance Generating Systems on Executive Functions: Effects and Mediating Processes.

Performance generating systems (PGS) are rule- and task-based approaches to improvisation on stage in theater, dance, and music. These systems require performers to draw on predefined source materials (texts, scores, memories) while working on complex tasks within limiting rules. An interdisciplinary research team at a large Western Canadian University hypothesized that learning to sustain this praxis over the duration of a performance places high demands on executive functions; demands that may improve the performers' executive abilities. These performers need to continuously shift attention while remaining responsive to embodied and environmental stimuli in the present, they are required to inhibit automated responses and impulses using the rules of the system, and they strive toward addressing multitasking challenges with fluidity and flexibility. This study set out to test the mentioned hypothesis deductively and identify mediating processes inductively, using mixed empirical methods. In a small sample experiment with a control group (28 participants; 15 in intervention group, 13 in control group), standardized quantitative tests of executive functions (D-KEFS) were administered before and after an 8-week intervention. Participant-reported qualitative observations from the praxis were also collected throughout the intervention for grounded analysis. Within the limitations of small sample data, we found both statistically significant and trending effects on inhibition, problem-solving initiation, fluidity, and cognitive flexibility. Examining the mediating process, we found that participants experienced significant challenges sustaining the practice halfway through the intervention. The participant-reported solutions to these challenges, which emerged as the strongest behavioral patterns when coding the qualitative data to saturation, were strategies of problem-solving and of re-directing attention. These strategies support and advance our understanding of the effects measured in the standardized tests. In terms of application, our results identify characteristics of PGS that could potentially maintain and strengthen executive functions over and above less demanding performing arts interventions. The results also deliver new insight into how PGS works, which may contribute to the development and teaching of this artistic practice.

A Review of School-Based Interventions to Reduce Stigma towards Schizophrenia.

Schizophrenia is among the most stigmatized mental illness. Adolescence may be a critical time to intervene, before stigmatizing attitudes have been solidified. As such, schools may be in a unique position to provide anti-stigma interventions to a large number of students. The aim of this paper was to review and critically analyze the most recent (2003-present) school-based schizophrenia stigma interventions, with seven studies identified. Studies were analyzed according to their intervention method, outcome measures, and experimental design. Substantial heterogeneity between studies precluded concrete conclusions or recommendations regarding the effectiveness of school-based schizophrenia stigma interventions. However, the most effective and informative studies utilized combinations of rigorous experimental design, psychometrically-validated measures examining multiple different factors related to stigma, and longer-term follow-up analyses. Future researchers are encouraged to utilize intervention methods and outcomes measures that are developed from and relevant to adolescent populations, rather than adapted from that of adults.

Neurochemical Correlates of Executive Function in Children with Attention-Deficit/Hyperactivity Disorder.

OBJECTIVES: Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder with no known biomarkers. The objectives of this study were 1) to investigate spectroscopic biomarkers in the right prefrontal cortex (R-PFC) and left striatum; 2) to evaluate Executive Function (EF) performance; and, 3) to examine the clinical relevance of glutamate in EF tasks. METHODS: A total of 21 children with ADHD (M = 10.41 years, SD = 1.41) and 15 controls without ADHD (M = 9.90 years, SD = 1.54 years) were enrolled. Short echo proton magnetic resonance spectroscopy (1H-MRS; TE = 30ms) was used to study the changes in the R-PFC and left striatum. Both groups completed an EF assessment battery, including working memory, inhibition, cognitive flexibility and verbal fluency tasks. RESULTS: In the R-PFC, independent t-tests found decreased concentration of glutamate (p = 0.009), NAA (p = 0.029) and choline (p = 0.016) in ADHD participants compared to controls. No significant differences were seen in the left striatum. Multivariate analysis of variance did not indicate overall EF challenges in the ADHD sample (p < .05). Positive correlations with glutamate concentration and EF performance in the control group were observed, however, no such correlations were reported in the ADHD group. CONCLUSIONS: The results indicated a subgroup of children with ADHD who presented with hypo-glutamatergic signalling in the R-PFC. Additionally, findings suggested a decoupling effect of glutamate in EF related tasks in children with ADHD compared to controls. Thus, glutamate concentration may be a possible ADHD biomarker and novel treatments target.

OBJECTIFS: Le trouble de déficit de l'attention avec hyperactivité (TDAH) est un trouble neurodéveloppemental prévalent sans biomarqueurs connus. Les objectifs de la présente étude étaient 1) de rechercher les biomarqueurs spectroscopiques du cortex préfrontal droit (CPF-D) et du striatum gauche; 2) d'évaluer le rendement de la fonction exécutive (FE); et 3) d'examiner la pertinence clinique du glutamate dans les tâches de la FE. MÉTHODES: Au total, 21 enfants souffrant du TDAH (M = 10,41 ans, ET = 1,41) et 15 témoins sans TDAH (M = 9,90 ans, ET = 1,54 an) ont été inscrits. La spectroscopie par résonance magnétique protonique à bref temps d'écho (1H-SRM; TE = 30 ms) a servi à étudier les changements dans le CPF-D et le striatum gauche. Les deux groupes ont passé une batterie de tests d'évaluation de la FE, dont les tâches de la mémoire de travail, l'inhibition, la flexibilité cognitive et la fluidité verbale. RÉSULTATS: Dans le CPF-D, les t-tests indépendants ont constaté une concentration réduite de glutamate (p = 0,009), de NAA (p = 0,029) et de choline (p = 0,016) chez les participants du TDAH comparés aux témoins. Aucune différence significative n'a été observée dans le striatum gauche. Des analyses multivariées de la variance n'ont pas indiqué de problèmes généraux pour la FE dans l'échantillon TDAH (p < 0,05). Des corrélations positives avec la concentration de glutamate et le rendement de la FE dans le groupe témoin ont été observées, toutefois, ces corrélations n'ont pas été observées dans le groupe du TDAH. CONCLUSIONS: Les résultats indiquaient un sous-groupe d'enfants souffrant du TDAH qui présentait un signal hypo-glutamatergique dans le CPF-D. En outre, les résultats suggéraient un effet de découplage du glutamate dans les tâches liées à la FE chez les enfants souffrant du TDAH comparés aux témoins. Ainsi, la concentration de glutamate peut être un biomarqueur du TDAH et une nouvelle cible de traitement.

Trait and Ability Emotional Intelligence in Children With ADHD.

OBJECTIVE: The purpose of this study was to examine trait and ability emotional intelligence (EI) in children with ADHD. METHOD: Forty-one children with ADHD (9-11 years) completed two measures of EI-the Bar-On Emotional Quotient Inventory: Youth Version-short form (EQi:YV-Brief) and the Mayer-Salovey-Caruso Emotional Intelligence Test, Youth Research Version (MSCEIT-YRV). RESULTS: Children with ADHD did not differ on total EI scores from the normative data on either the ability or trait EI measures. However, they scored above the group norms on the MSCEIT-YRV subscale of Managing Emotions and lower on Understanding Emotions. On the EQi:YV-Brief, children with ADHD reported significantly lower Interpersonal and Adaptability EI. CONCLUSION: Children with ADHD are relatively similar to children without ADHD when examining EI scores. However, there is some variability in the EI measures which should be considered when creating intervention programs.

Social Support in Children With ADHD: An Exploration of Resilience.

OBJECTIVE: This study investigated the role of perceived social support in promoting emotional well-being among children with ADHD. Specifically, it examined how children with ADHD perceive support from key individuals in their lives and the relationships between this support and aspects of emotional well-being. Main versus buffering models of social support in the context of social preference status were also explored. METHOD: Participants were 55 school-age children with ADHD-combined or hyperactive/impulsive (ADHD-C/HI). Parent and child ratings evaluated source-specific social support, social status, and aspects of self-concept, anxiety, and depression. RESULTS: Children with ADHD reported lower social support than normative samples. Social support had moderate positive associations with self-concept, with source-specific differences, but was not associated with internalizing symptoms. Regression models with social preference status supported a main effect model of perceived social support. CONCLUSION: Social support may provide a target for resilience-based interventions among children with ADHD in promoting their self-concept and well-being.

The relation between emotional intelligence and resilience in at-risk populations.

PURPOSE: Resilience factors and their relation to emotional intelligence (EI) as a potential strength for children with attention-deficit/hyperactivity disorder (ADHD) or high-functioning autism spectrum disorder (HFASD) were investigated. Children with either ADHD or HFASD were hypothesized to demonstrate reduced EI and differential relations between EI and resilience as compared to typically developing (TD) children. METHODS: Fifty-four children aged 8-12 years (18 with ADHD, 18 with HFASD, and 18 TD controls) completed the Resilience Scales for Children and Adolescents and BarOn Emotional Quotient Inventory. Differences between groups (analysis of variance) and unique relations among the variables (correlation) for each group were examined. RESULTS: No group differences; however, unique relations between the variables were found within each sample. CONCLUSIONS: EI may be a unique area of interest for clinical populations and an important consideration in the development and implementation of interventions to capitalize upon inherent strengths. Implications of these results for intervention are discussed.

Children with Attention Deficit/Hyperactivity Disorder and Reading Disability: A Review of the Efficacy of Medication Treatments.

Reading is a multifaceted skillset that has the potential to profoundly impact a child's academic performance and achievement. Mastery of reading skills is often an area of difficulty for children during their academic journey, particularly for children with Attention Deficit/Hyperactivity Disorder (ADHD), Specific Learning Disorder with Impairment in Reading (SLD-R), or children with a comorbid diagnosis of both ADHD and SLD-R. ADHD is characterized by executive functioning and impulse control deficits, as well as inattention and impulsivity. Among the academic struggles experienced by children with ADHD are challenges with word reading, decoding, or reading comprehension. Similarly, children with SLD-R frequently encounter difficulties in the development of appropriate reading skills. SLD-R incorporates dysfunctions in basic visual and auditory processes that result in difficulties with decoding and spelling words. There have been limited empirical studies investigating the efficacy of interventions to improve the reading ability of children with both ADHD and SLD-R. Research studies that have focused on reading interventions for children from this population have predominantly included the use of medication treatments with stimulants (e.g., methylphenidate) and non-stimulants (e.g., atomoxetine). This review paper will present and integrate findings from empirical studies on successful medication treatments for children with comorbid ADHD and SLD-R. Furthermore, this paper will extend findings from empirically successful medication treatments to provide directions for future research.

Processing of ironic language in children with high-functioning autism spectrum disorder.

We examined processing of verbal irony in three groups of children: (1) 18 children with high-functioning Autism Spectrum Disorder (HFASD), (2) 18 typically- developing children, matched to the first group for verbal ability, and (3) 18 typically-developing children matched to the first group for chronological age. We utilized an irony comprehension task that minimized verbal and pragmatic demands for participants. Results showed that children with HFASD were as accurate as typicallydeveloping children in judging speaker intent for ironic criticisms, but group differences in judgment latencies, eye gaze, and humor evaluations suggested that children with HFASD applied a different processing strategy for irony comprehension; one that resulted in less accurate appreciation of the social functions of irony.